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Operating Transverse Aortic Constriction with Absorbable Suture to Obtain Transient Myocardial Hypertrophy
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[Surgical treatment with modified Morrow procedure in hypertrophic obstructive cardiomyopathy]

Chang-qing Gao1, Chong-lei Ren, Cang-song Xiao

  • 1Department of Cardiovascular Surgery, Institute of Cardiac Surgery of People's Liberation Army, People's Liberation Army General Hospital, Beijing 100853, China. gaochq301@yahoo.com

Zhonghua Wai Ke Za Zhi [Chinese Journal of Surgery]
|August 14, 2012
PubMed

Insights

The modified Morrow procedure effectively reduces left ventricular outflow tract obstruction in hypertrophic obstructive cardiomyopathy (HOCM) patients. This surgery significantly improves symptoms and reduces the hypertrophied septum, offering a successful treatment option.

Area of Science:

  • Cardiovascular Surgery
  • Cardiology
  • Cardiac Anatomy

Context:

  • Hypertrophic obstructive cardiomyopathy (HOCM) presents a significant clinical challenge due to left ventricular outflow tract (LVOT) obstruction.
  • Systolic anterior motion (SAM) of the mitral valve and mitral regurgitation are common complications in HOCM.
  • The modified Morrow procedure, a type of ventricular septal myectomy, is employed to address these issues.

Purpose:

  • To evaluate the efficacy and outcomes of the modified Morrow procedure in patients diagnosed with HOCM.
  • To assess the impact of ventricular septal myectomy on LVOT gradient, septal thickness, and associated symptoms.

Summary:

  • Thirty-eight HOCM patients underwent ventricular septal myectomy (modified Morrow procedure) between June 2003 and March 2011.
  • Preoperative mean LVOT gradient of 89±31 mmHg decreased significantly to 18±13 mmHg post-surgery (1-2 weeks).
  • The procedure effectively resolved or improved SAM and mitral regurgitation, leading to asymptomatic status in all patients post-follow-up.

Impact:

  • The modified Morrow procedure demonstrates high effectiveness in managing HOCM, significantly reducing LVOT obstruction.
  • Successful surgery relies on adequate surgical exposure and complete resection of the hypertrophied septum.
  • Patients experience substantial symptomatic relief, including abolition of syncope and improvement in dyspnea.
Abstract

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